Alignment and engagement for teleoperated actuated surgical instrument

ABSTRACT

An instrument sterile adapter for coupling a surgical instrument and an instrument carriage includes an adapter control surface that extends control features of a control surface of the instrument carriage and receives an instrument control surface of the surgical instrument. A shaft receiving slot is positioned in the adapter control surface to receive an elongate tube of the surgical instrument when the adapter control surface receives the instrument control surface of the surgical instrument. The elongate tube may couple a proximal control mechanism of the surgical instrument to an end effector. The instrument sterile adapter may include a convex curved surface substantially perpendicular to and facing the adapter control surface to receive a corresponding concave curved surface on the instrument control surface. A bullet portion on the convex curved surface may engage a bullet receiving feature in the corresponding concave curved surface on the instrument control surface.

This application is related to and claims priority to U.S. applicationSer. No. 15/121,369 filed Aug. 24, 2016, entitled “Alignment andEngagement for Teleoperated Actuated Surgical Instrument”, which is aNational Stage Entry of PCT/US2015/020882 filed on Mar.17, 2015, whichclaims benefit of the following provisional applications:

U.S. 62/104,306 16 Jan. 2015 (16 Jan. 2015) U.S. 62/103,991 15 Jan. 2015(15 Jan. 2015) U.S. 62/019,318 30 Jun. 2014 (30 Jun. 2014) U.S.61/954,571 17 Mar. 2014 (17 Mar. 2014) U.S. 61/954,557 17 Mar. 2014 (17Mar. 2014) U.S. 61/954,502 17 Mar. 2014 (17 Mar. 2014) U.S. 61/954,49717 Mar. 2014 (17 Mar. 2014) U.S. 61/954,595 17 Mar. 2014 (17 Mar. 2014)Each of these applications is specifically incorporated herein byreference in their entirety and for all purposes.

FIELD

Embodiments of the invention relate to the field of field of alignmentguides; and more specifically, to alignment guides for attachingsurgical instruments to teleoperated actuators.

BACKGROUND

Minimally invasive medical techniques have been used to reduce theamount of extraneous tissue which may be damaged during diagnostic orsurgical procedures, thereby reducing patient recovery time, discomfort,and deleterious side effects. Traditional forms of minimally invasivesurgery include endoscopy. One of the more common forms of endoscopy islaparoscopy, which is minimally invasive inspection or surgery withinthe abdominal cavity. In traditional laparoscopic surgery, a patient'sabdominal cavity is insufflated with gas, and cannula sleeves are passedthrough small (approximately 12 mm) incisions in the musculature of thepatient's abdomen to provide entry ports through which laparoscopicsurgical instruments can be passed in a sealed fashion.

The laparoscopic surgical instruments generally include a laparoscopefor viewing the surgical field and surgical instruments having endeffectors. Typical surgical end effectors include clamps, graspers,scissors, staplers, and needle holders, for example. The surgicalinstruments are similar to those used in conventional (open) surgery,except that the working end or end effector of each surgical instrumentis separated from its handle by an approximately 30 cm. long extensiontube, for example, so as to permit the operator to introduce the endeffector to the surgical site and to control movement of the endeffector relative to the surgical site from outside a patient's body.

In order to provide improved control of the working tools, it may bedesirable to control the surgical instrument with teleoperatedactuators. The surgeon may operate controls on a console to indirectlymanipulate the instrument that is connected to the teleoperatedactuators. The surgical instrument is detachably coupled to theteleoperated actuators so that the surgical instrument can be separatelysterilized and selected for use as needed instrument for the surgicalprocedure to be performed. The surgical instrument may be changed duringthe course of a surgery.

Performing surgery with teleoperated surgical instruments creates newchallenges. One challenge is the need to maintain the region adjacentthe patient in a sterile condition. However, the motors, sensors,encoders and electrical connections that are necessary to control thesurgical instruments typically cannot be sterilized using conventionalmethods, e.g., steam, heat and pressure or chemicals, because they wouldbe damaged or destroyed in the sterilization process.

Another challenge with teleoperated surgery systems is that a number ofconnections are required between the surgical instrument and theteleoperated actuator and its controller. Connections are required totransmit the actuator forces, electrical signals, and data. This makesthe attachment of the surgical instrument to the teleoperated actuatorand its controller complex.

It would be desirable to provide an easier and more effective way toengage and disengage a surgical instrument and a teleoperated actuatordrive while preventing contamination of the teleoperated actuator andallowing quick and reliable attachment of a succession of surgicalinstruments that maintains a sterile area around the surgicalinstrument.

SUMMARY

An instrument sterile adapter for coupling a surgical instrument and aninstrument carriage includes an adapter control surface that extendscontrol features of a control surface of the instrument carriage andreceives an instrument control surface of the surgical instrument. Ashaft receiving slot is positioned in the adapter control surface toreceive an elongate tube of the surgical instrument when the adaptercontrol surface receives the instrument control surface of the surgicalinstrument. The elongate tube may couple a proximal control mechanism ofthe surgical instrument to an end effector. The instrument sterileadapter may include a convex curved surface substantially perpendicularto and facing the adapter control surface to receive a correspondingconcave curved surface on the instrument control surface. A bulletportion on the convex curved surface may engage a bullet receivingfeature in the corresponding concave curved surface on the instrumentcontrol surface.

Other features and advantages of the present invention will be apparentfrom the accompanying drawings and from the detailed description thatfollows below.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention may best be understood by referring to the followingdescription and accompanying drawings that are used to illustrateembodiments of the invention by way of example and not limitation. Inthe drawings, in which like reference numerals indicate similarelements:

FIG. 1 is a view of an illustrative patient-side portion of ateleoperated surgical system.

FIG. 2 is a side view of a surgical instrument for use with ateleoperated actuator.

FIG. 3 is a perspective view of an instrument sterile adapter (ISA).

FIG. 4 is a top perspective view of a latch plate.

FIG. 5 is a bottom perspective view of a latch plate.

FIG. 6 is an elevation view of a latch plate.

FIG. 7 is a perspective view of the instrument control surface.

FIG. 8 is a plan view of a portion of the instrument control surface.

FIG. 9 is a perspective view of the instrument control surface.

FIG. 10 is a side view of the ISA.

FIG. 11 is a top view of the ISA.

FIGS. 12-15 show the control surfaces of the ISA and the correspondingcontrol surfaces of the instrument control surface in various stages ofengagement.

DESCRIPTION OF EMBODIMENTS

In the following description, numerous specific details are set forth.However, it is understood that embodiments of the invention may bepracticed without these specific details. In other instances, well-knowncircuits, structures and techniques have not been shown in detail inorder not to obscure the understanding of this description.

In the following description, reference is made to the accompanyingdrawings, which illustrate several embodiments of the present invention.It is understood that other embodiments may be utilized, and mechanicalcompositional, structural, electrical, and operational changes may bemade without departing from the spirit and scope of the presentdisclosure. The following detailed description is not to be taken in alimiting sense, and the scope of the embodiments of the presentinvention is defined only by the claims of the issued patent.

The terminology used herein is for the purpose of describing particularembodiments only and is not intended to be limiting of the invention.Spatially relative terms, such as “beneath”, “below”, “lower”, “above”,“upper”, and the like may be used herein for ease of description todescribe one element's or feature's relationship to another element(s)or feature(s) as illustrated in the figures. It will be understood thatthe spatially relative terms are intended to encompass differentorientations of the device in use or operation in addition to theorientation depicted in the figures. For example, if the device in thefigures is turned over, elements described as “below” or “beneath” otherelements or features would then be oriented “above” the other elementsor features. Thus, the exemplary term “below” can encompass both anorientation of above and below. The device may be otherwise oriented(e.g., rotated 90 degrees or at other orientations) and the spatiallyrelative descriptors used herein interpreted accordingly.

As used herein, the singular forms “a”, “an”, and “the” are intended toinclude the plural forms as well, unless the context indicatesotherwise. It will be further understood that the terms “comprises”and/or “comprising” specify the presence of stated features, steps,operations, elements, and/or components, but do not preclude thepresence or addition of one or more other features, steps, operations,elements, components, and/or groups thereof.

The term “object” generally refers to a component or group ofcomponents. For example, an object may refer to either a pocket or aboss of a disk within the specification or claims. Throughout thespecification and claims, the terms “object,” “component,” “portion,”“part” and “piece” are used interchangeably.

The terms “instrument” and “surgical instrument”are used herein todescribe a medical device configured to be inserted into a patient'sbody and used to carry out surgical or diagnostic procedures. Theinstrument includes an end effector. The end effector may be a surgicaltool associated with one or more surgical tasks, such as a forceps, aneedle driver, a shears, a bipolar cauterizer, a tissue stabilizer orretractor, a clip applier, an anastomosis device, an imaging device(e.g., an endoscope or ultrasound probe), and the like. Some instrumentsused with embodiments of the invention further provide an articulatedsupport (sometimes referred to as a “wrist”) for the surgical tool sothat the position and orientation of the surgical tool can bemanipulated with one or more mechanical degrees of freedom in relationto the instrument's shaft. Further, many surgical end effectors includea functional mechanical degree of freedom, such as jaws that open orclose, or a knife that translates along a path. Surgical instruments mayalso contain stored (e.g., on a semiconductor memory inside theinstrument) information that may be permanent or may be updatable by thesurgical system. Accordingly, the system may provide for either one-wayor two-way information communication between the instrument and one ormore system components.

The terms “or” and “and/or” as used herein are to be interpreted asinclusive or meaning any one or any combination. Therefore, “A, B or C”or “A, B and/or C” mean “any of the following: A; B; C; A and B; A andC; B and C; A, B and C.” An exception to this definition will occur onlywhen a combination of elements, functions, steps or acts are in some wayinherently mutually exclusive.

FIG. 1 is a view of an illustrative patient-side portion 100 of ateleoperated surgical system, in accordance with embodiments of thepresent invention. The patient-side portion 100 includes supportassemblies 110 and one or more surgical instrument manipulators 112 atthe end of each support assembly. The support assemblies optionallyinclude one or more unpowered, lockable setup joints that are used toposition the surgical instrument manipulator(s) 112 with reference tothe patient for surgery. As depicted, the patient-side portion 100 restson the floor. In other embodiments the patient-side portion may bemounted to a wall, to the ceiling, to the operating table 126, whichalso supports the patient's body 122, or to other operating roomequipment. Further, while the patient-side portion 100 is shown asincluding four manipulators 112, more or fewer manipulators 112 may beused. Still further, the patient-side portion 100 may consist of asingle assembly as shown, or it may include two or more separateassemblies, each optionally mounted in various possible ways.

Each surgical instrument manipulator 112 supports one or more surgicalinstruments 120 that operate at a surgical site within the patient'sbody 122. Each manipulator 112 may be provided in a variety of formsthat allow the associated surgical instrument to move with one or moremechanical degrees of freedom (e.g., all six Cartesian degrees offreedom, five or fewer Cartesian degrees of freedom, etc.). Typically,mechanical or control constraints restrict each manipulator 112 to moveits associated surgical instrument around a center of motion on theinstrument that stays stationary with reference to the patient, and thiscenter of motion is typically located to be at the position where theinstrument enters the body.

A functional teleoperated surgical system will generally include avision system portion (not shown) that enables the operator to view thesurgical site from outside the patient's body 122. The vision systemtypically includes a surgical instrument that has a video-image-capturefunction 128 (a “camera instrument”) and one or more video displays fordisplaying the captured images. In some surgical system configurations,the camera instrument 128 includes optics that transfer the images fromthe distal end of the camera instrument 128 to one or more imagingsensors (e.g., CCD or CMOS sensors) outside of the patient's body 122.Alternatively, the imaging sensor(s) may be positioned at the distal endof the camera instrument 128, and the signals produced by the sensor(s)may be transmitted along a lead or wirelessly for processing and displayon the video display. An illustrative video display is the stereoscopicdisplay on the surgeon's console in surgical systems commercialized byIntuitive Surgical, Inc., Sunnyvale, Calif.

A functional teleoperated surgical system will further include a controlsystem portion (not shown) for controlling the movement of the surgicalinstruments 120 while the instruments are inside the patient. Thecontrol system portion may be at a single location in the surgicalsystem, or it may be distributed at two or more locations in the system(e.g., control system portion components may be in the system'spatient-side portion 100, in a dedicated system control console, or in aseparate equipment rack). The teleoperated master/slave control may bedone in a variety of ways, depending on the degree of control desired,the size of the surgical assembly being controlled, and other factors.In some embodiments, the control system portion includes one or moremanually-operated input devices, such as a joystick, exoskeletal glove,a powered and gravity-compensated manipulator, or the like. These inputdevices control teleoperated motors which, in turn, control the movementof the surgical instrument.

The forces generated by the teleoperated motors are transferred viadrivetrain mechanisms, which transmit the forces from the teleoperatedmotors to the surgical instrument 120. In some telesurgical embodiments,the input devices that control the manipulator(s) may be provided at alocation remote from the patient, either inside or outside the room inwhich the patient is placed. The input signals from the input devicesare then transmitted to the control system portion. Persons familiarwith telemanipulative, teleoperative, and telepresence surgery will knowof such systems and their components, such as the da Vinci® SurgicalSystem commercialized by Intuitive Surgical, Inc. and the Zeus® SurgicalSystem originally manufactured by Computer Motion, Inc., and variousillustrative components of such systems.

As shown, both the surgical instrument 120 and an optional entry guide124 (e.g., a cannula in the patient's abdomen) are removably coupled tothe distal end of a manipulator 112, with the surgical instrument 120inserted through the entry guide 124. Teleoperated actuators in themanipulator 112 move the surgical instrument 120 as a whole. Themanipulator 112 further includes an instrument carriage 130. Thesurgical instrument 120 is detachably connected to the carriage 130. Theteleoperated actuators housed in the carriage 130 provide a number ofcontroller motions which the surgical instrument 120 translates into avariety of movements of the end effector on the surgical instrument.Thus the teleoperated actuators in the carriage 130 move only one ormore components of the surgical instrument 120 rather than theinstrument as a whole. Inputs to control either the instrument as awhole or the instrument's components are such that the input provided bya surgeon to the control system portion (a “master” command) istranslated into a corresponding action by the surgical instrument (a“slave” response).

FIG. 2 is a side view of an illustrative embodiment of the surgicalinstrument 120, comprising a distal portion 250 and a proximal controlmechanism 240 coupled by an elongate tube 210. The distal portion 250 ofthe surgical instrument 120 may provide any of a variety of endeffectors such as the forceps 254 shown, a needle driver, a cauterydevice, a cutting tool, an imaging device (e.g., an endoscope orultrasound probe), or a combined device that includes a combination oftwo or more various tools and imaging devices. In the embodiment shown,the end effector 254 is coupled to the elongate tube 210 by a “wrist”252 that allows the orientation of the end effector to be manipulatedwith reference to the instrument tube 210.

Surgical instruments that are used with the invention may control theirend effectors (surgical tools) with a plurality of rods and/or flexiblecables. Rods, which may be in the form of tubes, may be combined withcables to provide a “push/pull” control of the end effector with thecables providing flexible sections as required. A typical elongate tube210 for a surgical instrument 120 is small, perhaps five to eightmillimeters in diameter, roughly the diameter of a large soda straw. Thediminutive scale of the mechanisms in the surgical instrument 120creates unique mechanical conditions and issues with the construction ofthese mechanisms that are unlike those found in similar mechanismsconstructed at a larger scale, because forces and strengths of materialsdo not scale at the same rate as the size of the mechanisms. The cablesmust fit within the elongate tube 210 and be able to bend as they passthrough the wrist joint 252.

In order to provide a sterile operation area while using a functionalteleoperated surgical system, it is preferred that a barrier be placedbetween the non-sterile system and the sterile surgical field.Therefore, a sterile component, such as an instrument sterile adapter(ISA), is placed between the surgical instrument 120 and theteleoperated surgical instrument manipulator 130. The placement of aninstrument sterile adapter between the surgical instrument 120 and thesurgical instrument manipulator 130 includes the benefit of ensuring asterile coupling point for the surgical instrument 120 and the surgicalinstrument manipulator 130. This permits removal of surgical instrumentsfrom the surgical instrument manipulator 130 and exchange with othersurgical instruments during the course of a surgery.

FIG. 3 is a perspective view of a setup joint that supports the carriage130 which in turn supports the surgical instrument 120 on a strut 310.In preparation for surgery, the setup joint is covered with a steriledrape 300. The sterile drape protects the setup joint from contaminationand provides a sterile surface around the setup joint. The majority ofthe sterile drape 300 is a plastic sheet, which may be in the form of atube or bag, that covers the arms of the setup joint. For example, asingle layer thermoplastic polyurethane (TPU) may be used. A lubricantmay be included to reduce the tackiness of the plastic. The sheet may beabout 100 micrometers (0.004 inch) thick. Other suitable materials maybe used for the sheet.

FIG. 4 is a perspective view of the strut 310 portion of the setup jointthat supports the carriage 130. The sterile drape is not shown to allowthe carriage 130 to be seen more clearly. One surface 400 of thecarriage provides a number of mechanical and electrical interfaces tocommunicate mechanical motion and data signals between the controlsystem, the teleoperated actuators, and the surgical instrument. It willbe appreciated that the connections to the surgical instrument mayrequire a penetration through the sterile drape. It is difficult toprovide a penetration through the plastic sheet that is compatible withthe connections between the carriage 130 and a surgical instrument.Further, the carriage 130 is shaped to allow the elongate tube 210 (FIG.2) of the surgical instrument 120 to pass through an indentation 410along one side of the carriage. It is difficult to drape the carriagewith the plastic sheet due to the shape of the carriage.

FIG. 5 is a perspective view of the portion of the sterile drape that isconstructed to be placed around the carriage 130. The sterile drapeincludes three portions. The first portion is the plastic sheet 300described above. The second portion is a pouch 500 shaped to fit aroundthe carriage 130. The third portion is a largely rigid instrumentsterile adapter (ISA) 510 that engages the control features 400 of thecarriage 130 and provides a sterile counterpart of the control featuresfor connection to a surgical instrument. The sterile drape is adisposable assembly.

The pouch 500 may be made from a material such as a cast urethane. Thepouch 500 may be flexible but it should return to its original shapewhen not subject to stress. The pouch provides a portion of the drapethat is a loose form fit around the carriage 130 to provide a clear workspace for the teleoperated actuators and the surgical instrument.

An aperture 520 is formed in the plastic sheet 300 where the pouch 500is joined to the plastic sheet. The plastic sheet may be joined to thepouch by any process that is compatible with the materials of the sheetand the pouch, such as by heat welding.

FIG. 6 is a perspective view of the control surface 400 of the carriage,the ISA 510, and proximal control 240 of a surgical instrument that hasbeen rotated to show the instrument control surface 242. The ISA 510 iscoupled to the control surface 400 of the carriage as suggested by thefigure. The ISA 510 provides an adapter control surface that extends thecontrol features of the control surface 400 of the carriage 130 as asterile, disposable surface that can receive the proximal control 240 ofthe teleoperated actuated surgical instrument 120 and engage the controlfeatures of the instrument control surface 242.

The ISA 510 includes a curved surface 606 that receives a correspondingcurved surface 600 on the instrument control surface 242 as theinstrument is being placed on the ISA. The curved surface 606 of the ISAis substantially perpendicular direction to the adapter control surface.The curved surfaces 600, 606 work in concert with the instrument shaft210 location in the entry guide 124 and a shaft receiving slot 616 inthe ISA to locate the instrument roughly in the plane parallel to thecontrol surface of the ISA. The entry guide 124 constrains theinstrument shaft 210 to rotation around a cylindrical axis of theinstrument shaft and axial translation along the cylindrical axis of theinstrument shaft. The curved surfaces 600, 606 of the ISA and theinstrument control surface 242 tend to constrain the instrument controlsurface to rotation about the cylindrical axis of the ISA curved surface606 and translation along the ISA curved surface. Since the cylindricalaxis of the instrument shaft and the cylindrical axis of the ISA curvedsurface are spaced apart, they provide an effective constraint on theposition of the instrument control surface.

Further insertion of the instrument shaft 210 into the entry guide 124causes the instrument's bullet receiving feature 604 to engage thebullet portion 608 of the ISA curved surface 606. This combination moretightly constrains the instrument movements.

As the instrument control surface 242 approaches the ISA, latch arms 614on the ISA enter latch receptacles 618 on the surgical instrument'sproximal control 240. The latch receptacles 618 may provide a slopedsurface to further aid in positioning the instrument control surface242. It will be appreciated that the latch arms 614 are movable and thattheir positioning function is secondary to their primary latchingfunction.

When the instrument is fully installed onto the ISA control surface, alocating pin 610 on the ISA enters a locating slot 612 on the instrumentcontrol surface 242 to tightly constrain movement of the proximalcontrol 240 in the plane of the instrument control surface 242. Theproximal control 240 is further constrained by the landing pads 602 onthe ISA that support the control surface 242 of the instrument. When theproximal control 240 is latched to the ISA, the landing pads 602 on theISA tightly constrain movement of the proximal control 240 perpendicularto the plane of the instrument control surface 242.

FIG. 7 is a perspective view of the instrument control surface 242 atthe start of the installation onto the ISA 510. The curved surface 600on the instrument control surface 242 is shown as it engages thecorresponding curved surface 606 on the ISA 510. The remainder of thesurgical instrument's proximal control is not shown to allow the curvedsurface 600 on the instrument control surface 242 to be seen moreclearly.

FIG. 8 is a plan view of a portion of the instrument control surface 242showing the locating slot 612 that receives the locating pin 610. Thelower end of the bullet portion 608 acts somewhat like a pin in a holealthough being a half-pin in a half-hole it cannot completely constrainthe position of instrument control surface 242. The bullet portion 608works with the locating pin 610 and locating slot 612 to control thetendency of the instrument control surface 242 to rotate in reaction tothe applied rotary control torques. The locating slot 612 is onlyextended lengthwise by a small amount to compensate for the lack ofcontrol by the bullet feature. In another embodiment, not shown, thelocating pin is on the instrument control surface and the locating slotis on the ISA.

FIG. 9 is a perspective view of the instrument control surface 242 fullyinstalled onto the ISA 510.

FIG. 10 is a side view of the ISA 510. It will be seen that the curvedsurface 606 on the ISA 510 provides a locating surface when theinstrument control surface first engages the ISA. The bullet portion 608provides a locating surface when the instrument control surface is movedcloser to the ISA. The latch arms 614 contribute to the positioning ofthe instrument control surface as it moves still closer to the ISA. Thelocating pin 610 engages the instrument control surface and provides thefinal positioning and constraint of the instrument control surface 242as the lower surface reaches the landing pads 602.

FIG. 11 is a top view of the ISA 510. The control surfaces—the landingpads 602, the curved surface 606, the bullet portion 608, the locatingpin 610, the latch arms 614, and the shaft receiving slot 616—have beenhighlighted with heavier lines.

FIGS. 12-15 show the control surfaces of the ISA 510 and thecorresponding control surfaces of the instrument control surface 242 invarious stages of engagement.

FIG. 12 shows the initial engagement of the instrument control surface242 with the ISA 510. The position of the instrument control surface 242is constrained by the engagement of the curved surface 600 on theinstrument control surface 242 with the corresponding curved surface 606on the ISA 510 and by the instrument shaft 210 in the instrument guide(not shown) and the shaft receiving slot 616. As can be seen, theinstrument control surface 242 is only loosely constrained during theinitial engagement. This allows the surgical instrument to be easilyengaged with the ISA to start the process of bringing the surgicalinstrument into an accurately positioned latched engagement with theISA. It will be appreciated that the surgical draping associated withthe ISA and other visual obstacles may require attaching the surgicalinstrument to the ISA with little or no view of the surfaces beingengaged.

FIG. 13 shows the instrument control surface 242 when the bulletreceiving feature 604 on the instrument control surface 242 engages thebullet portion 608 on the ISA 510. As can be seen, engaging the bulletportion 608 greatly increases the constraint on the position of theinstrument control surface 242. The leading portion of the bulletportion 608 is tapered to aid in engaging the bullet portion. But theengagement of the curved surface 600 on the instrument control surface242 with the corresponding curved surface 606 on the ISA 510 allows theinstrument control surface to be moved along a controlled path thatassists with engaging the bullet portion 608 even if the bulletreceiving feature 604 is not initially aligned with the leading portionof the bullet portion.

FIG. 14 shows the instrument control surface 242 when the latch arms 614on the ISA 510 enter the latch receptacles 618 on the instrument controlsurface. While the engagement of the bullet portion 608 largely alignsthe instrument control surface 242 so the latch arms 614 can readilyenter the latch receptacles 618, the latch receptacles may be shaped sothat engaging the latch arms further positions the instrument controlsurface.

FIG. 15 shows the instrument control surface 242 when the locating pin610 on the ISA 510 has engaged the locating slot 612 on the instrumentcontrol surface. Engaging the locating pin 610 on the ISA 510 with thelocating slot 612 on the instrument control surface 242 and engaging thebullet receiving feature 604 on the instrument control surface 242 withthe bullet portion 608 on the ISA 510 constrains the movement betweenthe instrument control surface and the ISA parallel to the plane of theinstrument control surface (parallel to the plane of the figure). Aspreviously discussed, the locating pin 610 and the bullet portion 608also provide a torque reaction feature to prevent twisting of thesurgical instrument's proximal control 240 in reaction to the torquesapplied to the instrument by the teleoperated actuators as transmittedthrough the ISA 510.

While certain exemplary embodiments have been described and shown in theaccompanying drawings, it is to be understood that such embodiments aremerely illustrative of and not restrictive on the broad invention, andthat this invention is not limited to the specific constructions andarrangements shown and described, since various other modifications mayoccur to those of ordinary skill in the art. The description is thus tobe regarded as illustrative instead of limiting.

What is claimed is:
 1. An instrument sterile adapter for coupling asurgical instrument and an instrument carriage, the instrument sterileadapter comprising: an adapter control surface that extends controlfeatures of a control surface of the instrument carriage and receives aninstrument control surface of the surgical instrument; and a shaftreceiving slot positioned in the adapter control surface to receive anelongate tube of the surgical instrument when the adapter controlsurface receives the instrument control surface of the surgicalinstrument.
 2. The instrument sterile adapter of claim 1, furthercomprising a surface perpendicular to the adapter control surface andcoupled to the adapter control surface opposite the shaft receivingslot.
 3. The instrument sterile adapter of claim 2, wherein the surfaceperpendicular to the adaptor control surface comprises a curved surface.4. The instrument sterile adapter of claim 2, wherein the curved surfacecomprises a convex curved surface facing the adapter control surface andreceiving a corresponding concave surface on the instrument controlsurface on the condition the adapter control surface receives theinstrument control surface.
 5. The instrument sterile adapter of claim4, further comprising a bullet portion on the convex curved surface thatengages a bullet receiving feature in the corresponding concave curvedsurface on the instrument control surface.
 6. The instrument sterileadapter of claim 5, wherein the bullet portion further comprises atapered leading portion.
 7. The instrument sterile adapter of claim 1,further comprising a locating pin on the adapter control surface thatengages a locating slot on the instrument control surface.
 8. Theinstrument sterile adapter of claim 1, further comprising a locatingslot on the adapter control surface that engages a locating pin on theinstrument control surface.
 9. The instrument sterile adapter of claim1, further comprising a plurality of landing pads on the adapter controlsurface that support the instrument control surface.
 10. The instrumentsterile adapter of claim 1, further comprising latch arms on the adaptercontrol surface that engage latch receptacles on the instrument controlsurface.
 11. A method of aligning a surgical instrument with aninstrument sterile adapter for coupling the surgical instrument and aninstrument carriage, the method comprising: inserting an instrumentshaft of the surgical instrument into an entry guide held in a fixedrelation to the instrument carriage and the instrument sterile adapter,insertion of the instrument shaft into the entry guide constraining thesurgical instrument to rotation around a first cylindrical axis of theinstrument shaft and axial translation along the first cylindrical axisof the instrument shaft; and passing the instrument shaft of thesurgical instrument through a shaft receiving slot of the instrumentsterile adapter.
 12. The method of claim 11, further comprising engaginga curved surface of the instrument sterile adapter with a correspondingcurved surface on an instrument control surface of the surgicalinstrument to constrain rotation around the first cylindrical axis ofthe instrument shaft, the curved surface having a second cylindricalaxis that is spaced apart from the first cylindrical axis of theinstrument shaft.
 13. The method of claim 12, further comprisingengaging a bullet portion on the curved surface of the instrumentsterile adapter with a bullet receiving feature in the correspondingcurved surface on the instrument control surface to further constrainthe surgical instrument.
 14. The method of claim 13, further comprisingengaging a tapered leading portion of the bullet portion to guide thebullet receiving feature onto the bullet portion.
 15. The method ofclaim 11, further comprising engaging a locating pin on an adaptercontrol surface of the instrument sterile adapter with a locating sloton the instrument control surface to further constrain the surgicalinstrument.
 16. The method of claim 11, further comprising engaging alocating slot on an adapter control surface of the instrument sterileadapter with a locating pin on the instrument control surface to furtherconstrain the surgical instrument.
 17. The method of claim 11, furthercomprising supporting the instrument control surface on a plurality oflanding pads on an adapter control surface of the instrument sterileadapter.
 18. The method of claim 11, further comprising engaging latcharms on an adapter control surface of the instrument sterile adapterwith latch receptacles on the instrument control surface.
 19. Aninstrument sterile adapter for coupling a surgical instrument and aninstrument carriage, the instrument sterile adapter comprising: meansfor extending control features of a control surface of the instrumentcarriage to an instrument control surface of the surgical instrument;and means for receiving an elongate tube of the surgical instrumentthrough the means for extending on the condition the means for extendingreceives the instrument control surface, the elongate tube coupling acontrol mechanism of the surgical instrument to an end effector of thesurgical instrument.
 20. The instrument sterile adapter of claim 19,further comprising: means for constraining the surgical instrument torotation around a first cylindrical axis of an instrument shaft andaxial translation along the first cylindrical axis of the instrumentshaft; means for limiting the rotation of the surgical instrument aroundthe first cylindrical axis of the instrument shaft; and means forfurther constraining the surgical instrument to rotation around a secondcylindrical axis of a curved surface of the instrument sterile adapter.